LA Pizza Mia

New Iberia, LA

Broussard, LA

Community

We Love Our Communities!

If you’re a school, team, troop, or a non-profit organization (501-3C or 501 C7), we want to help you raise MONEY!

To be considered for a fundraiser, please complete the form below and submit to us.

One organization will be selected each quarter of the year, 4 per year, whereby 10% of all sales for the day, on a Monday decided upon collaboratively, will be donated to your organization.

*Your organization’s form must be remitted and approved thirty (30) days prior to the desired fundraiser date. This will allow proper promotion of your event.

Welcome to your first step to raising some serious cash for your organization. Please complete the form below, and let’s have some fun and raise some money! LA Pizza Mia reserves the right to select organizations we choose to support.

Today's Date* (required)

Your Name* (required)

Your Email* (required)

Your Phone* (required)

Fundraising Organization Name* (required)

Type of Organization* (required)

Fundraiser Date* (required)

Describe Event* (required)

Organization Information

Organization Name *

Address * (required)

City * (required)

State * (required)

Zip * (required)

* (required)

Contact Name * (required)

Contact's Position * (required)

Contact's Phone * (required)

Contact's Fax * (required)

Contact's Email * (required)

Contact's State * (required)

Mailing Address of Check

Check Made Out To * (required)

Address * (required)

City * (required)

State * (required)

Zip * (required)

Organization's Tax Information

Federal Tax ID#

Are you recognized by the government as a non-profit organization?

Agreement Terms: Approval of this agreement is at the sole discretion of LA Pizza Mia. Please note that this agreement must be approved at least thirty (30) days before your scheduled fundraiser event. This agreement may be terminated and/or cancelled on thirty (30) day’s written notice at any time during the term of this agreement by either party. The above organization will promote this fundraiser event for the above LA Pizza Mia location only. The proceeds for the event will be up to 10% of the pre-tax sale receipts for food and beverages. Participants must purchase a beverage with their meal in order to receive credit towards the organization. One beverage per meal purchase. One flyer required per transaction. No other coupons or discounts may be applied. By clicking the check box below, I understand that all flyers are to be distributed prior to the event, and under no circumstances are flyers to be handed out in the restaurant, parking lot, or vicinity. The event traditionally takes place between the hours of 5 p.m. and 8 p.m. unless otherwise approved and noted on the contact by the General Manager of the above restaurant. A check will be mailed to the organization within 4-6 weeks after the event. No guarantees or warranties of any kind are made by either party here to as the anticipated success of this event.